Canadian Oxygen Trial (COT)

NCT ID: NCT00637169

Last Updated: 2018-03-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2012-12-31

Brief Summary

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Study Question: In infants who are born at gestational ages of 23 0/7 to 27 6/7 weeks, does lowering the concentration of supplemental oxygen to target an arterial oxygen saturation by pulse oximetry (SpO2)of 85-89% compared with 91-95%, from the day of birth until the baby's first discharge home, increase the probability of survival without severe neurosensory disability to a corrected age of 18 months?

Detailed Description

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Most extremely preterm babies require supplemental oxygen for several weeks or even months after birth. The goal of oxygen therapy is to achieve adequate oxygen delivery to the tissues without causing oxygen toxicity and oxidative stress. At present, this goal is elusive in very immature infants. Although it is standard practice in modern neonatal intensive care units to monitor arterial oxygen saturations via pulse oximetry, there is insufficient evidence to guide the choice of the upper and lower alarm limits. A rigorous trial with long-term follow up is urgently needed and long overdue to determine whether oxygen exposure can be reduced safely in extremely preterm infants without increasing the risk of hypoxic death or disability.

Conditions

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Respiratory Insufficiency of Prematurity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

Supplemental oxygen to maintain functional arterial oxygen saturations in the range of 85-89%. Dose of oxygen is determined by the individual infant's need to achieve the target oxygen saturations.

Group Type EXPERIMENTAL

Titration of oxygen therapy

Intervention Type OTHER

Supplemental oxygen to maintain functional arterial oxygen saturations in one of two saturation target ranges.

2

Supplemental oxygen to maintain functional arterial oxygen saturations in the range of 91-95%. Dose of oxygen is determined by the individual infant's need to achieve the target oxygen saturations.

Group Type ACTIVE_COMPARATOR

Titration of oxygen therapy

Intervention Type OTHER

Supplemental oxygen to maintain functional arterial oxygen saturations in one of two saturation target ranges.

Interventions

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Titration of oxygen therapy

Supplemental oxygen to maintain functional arterial oxygen saturations in one of two saturation target ranges.

Intervention Type OTHER

Other Intervention Names

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Masimo Radical Pulse Oximeter

Eligibility Criteria

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Inclusion Criteria

* Gestational age 23 0/7 - 27 6/7 weeks
* Postnatal age \< 24 hours

Exclusion Criteria

* Infant not considered viable (decision made not to administer effective therapies)
* Dysmorphic features or congenital malformations that adversely affect life expectancy or neurodevelopment
* Known or strongly suspected cyanotic heart disease
* Persistent pulmonary hypertension, e.g. associated with pulmonary hypoplasia
* Unlikely to be available for long-term follow-up
Maximum Eligible Age

24 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Barbara Schmidt, MD

Role: STUDY_CHAIR

McMaster University

Robin Roberts, MMath

Role: PRINCIPAL_INVESTIGATOR

Hamilton Health Sciences/McMaster University

Elizabeth Asztalos, MD

Role: PRINCIPAL_INVESTIGATOR

Sunnybrook Health Sciences Centre

Alfonso Solimano, MD

Role: PRINCIPAL_INVESTIGATOR

Children's & Women's Health Centre of BC

Robin Whyte, MD

Role: PRINCIPAL_INVESTIGATOR

IWK Health Centre

Jack Rabi, MD

Role: PRINCIPAL_INVESTIGATOR

Foothills Hospital

Christian Poets, MD

Role: PRINCIPAL_INVESTIGATOR

University Children's Hospital Tuebingen

Locations

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Stony Brook University Medical Center

Stony Brook, New York, United States

Site Status

Pennsylvania Hospital

Philadelphia, Pennsylvania, United States

Site Status

Hospital of the University of Pennsylvania (HUP)

Philadelphia, Pennsylvania, United States

Site Status

Hospital Sanatorio de la Trinidad & Buenos Aires NICU Network

Buenos Aires, , Argentina

Site Status

Foothills Hospital

Calgary, Alberta, Canada

Site Status

Royal Alexandra Hospital

Edmonton, Alberta, Canada

Site Status

B.C. Children's Hospital

Vancouver, British Columbia, Canada

Site Status

St. Boniface General Hospital

Winnipeg, Manitoba, Canada

Site Status

Winnipeg Health Sciences Centre

Winnipeg, Manitoba, Canada

Site Status

IWK Health Centre

Halifax, Nova Scotia, Canada

Site Status

McMaster University Medical Centre

Hamilton, Ontario, Canada

Site Status

Children's Hospital of Eastern Ontario and Ottawa General Hospital

Ottawa, Ontario, Canada

Site Status

Mount Sinai Hospital

Toronto, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

Royal Victoria Hospital

Montreal, Quebec, Canada

Site Status

CHU Ste. Justine

Montreal, Quebec, Canada

Site Status

Centre Hospitalier Universitaire de Quebec

Québec, Quebec, Canada

Site Status

Royal University Hospital

Saskatoon, Saskatchewan, Canada

Site Status

Oulu University Central Hospital

Oulu, , Finland

Site Status

University Children's Hospital

Tübingen, , Germany

Site Status

Soroka University Medical Center

Beersheba, , Israel

Site Status

Bnai-Zion Medical Center

Haifa, , Israel

Site Status

Meir Medical Center

Kfar Saba, , Israel

Site Status

Countries

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United States Argentina Canada Finland Germany Israel

References

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Schmidt B, Whyte RK, Asztalos EV, Moddemann D, Poets C, Rabi Y, Solimano A, Roberts RS; Canadian Oxygen Trial (COT) Group. Effects of targeting higher vs lower arterial oxygen saturations on death or disability in extremely preterm infants: a randomized clinical trial. JAMA. 2013 May 22;309(20):2111-20. doi: 10.1001/jama.2013.5555.

Reference Type RESULT
PMID: 23644995 (View on PubMed)

Schmidt B, Roberts RS, Whyte RK, Asztalos EV, Poets C, Rabi Y, Solimano A, Nelson H; Canadian Oxygen Trial Group. Impact of study oximeter masking algorithm on titration of oxygen therapy in the Canadian oxygen trial. J Pediatr. 2014 Oct;165(4):666-71.e2. doi: 10.1016/j.jpeds.2014.05.028. Epub 2014 Jun 25.

Reference Type RESULT
PMID: 24973289 (View on PubMed)

Jensen EA, Whyte RK, Schmidt B, Bassler D, Vain NE, Roberts RS; Canadian Oxygen Trial Investigators. Association between Intermittent Hypoxemia and Severe Bronchopulmonary Dysplasia in Preterm Infants. Am J Respir Crit Care Med. 2021 Nov 15;204(10):1192-1199. doi: 10.1164/rccm.202105-1150OC.

Reference Type DERIVED
PMID: 34428130 (View on PubMed)

Other Identifiers

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MCT-79217/ISRCTN62491227

Identifier Type: -

Identifier Source: secondary_id

NTG-2006-COT

Identifier Type: -

Identifier Source: org_study_id

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